Clodronate, a 1st generation, non-nitrogenous, bisphosphonate drug, has revolutionized how equine practitioners treat navicular syndrome in horses.
Clodronate is a game-changer for treating navicular syndrome
Historically, navicular syndrome is a common but difficult to treat problem in athletic horses, causing lameness that negatively impacts their ability to train and perform. Prior to the availability of clodronate, equine practitioners had limited options available to help keep a sore horse in work. Years of clinical insight into its efficacy and safety has given the panelists the confidence to administer clodronate as part of a comprehensive management regime to help keep heel-sore horses more comfortable than they were able to in the past.
“I think [clodronate] gives us another tool in our tool box to address some of these issues that have potentially been refractory to other treatment modalities. In my practice it is just part of what I do [...]. There will be shoeing changes, work changes, looking at footing. It's sort of the holistic approach.”
The efficacy of clodronate on improving lameness in heel-sore horses has also enabled practitioners to reduce the frequency of more invasive-and potentially more expensive-procedures such as intra-articular injections.
“Over the last 5 years or so, I’ve seen these horses maintain a level of comfort and an ability to perform for longer periods of time without intra-articular intervention—and clients are happier.”
Clodronate has been an especially beneficial asset for sport horses that experience chronic or recurring lameness, which is not uncommon in performance horses. The ability to safely re-dose-if indicated-can help extend the careers of horses whose recurring lameness issues may have put them out of work permanently before the availability of clodronate as a treatment option.
“They’re athletes, and so you’re going to expect bumps in the road all the way through. With those clients we do this continued work for, bisphosphonate is another opportunity to have that conversation that ‘OK, we’re going to do this. It may fix this particular problem, and you’ll go on.’”
Changing the medical management of performance horses
Beyond the direct, clinical benefits that clodronate has on improving signs of navicular syndrome and other painful bone conditions, it has also changed how the panelists approach the overall management scheme for equine patients as more of a mutual effort between the practitioner and the client.
The inclusion of clodronate in a horse’s treatment regimen has opened the doors for client education. It presents the opportunity to discuss the importance of medical imaging to pinpoint the horse’s exact affliction in order to choose an appropriate treatment option. With a greater emphasis on achieving an accurate diagnosis, the practitioner and client can work together to determine the best, targeted treatment plan for the horse, shifting away from the previously common paradigm of routine or preventative administration of medication, whether or not it is indicated.
“[Bisphosphonates have] been a game changer in navicular disease. I can now manage it much better than I could 10 or 15 years ago. It has also allowed me now as I find areas of bony inflammation in other parts of the body, to have some more effective tools in conjunction with the other tools I'm using. So that's how it worked for me.”